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Septoplasty Vs Rhinoplasty for Crooked Nose?

I have a crooked nose. Will Septoplasty fix it or will I need Rhinoplasty as well? Are there any closed options available? Looking at my picture, if I get Septoplasty, should I get Rhinoplasty anyway to make my nose smaller?

Doctor Answers 26

Correcting a Crooked Nose

A septoplasty is a surgery performed to correct a deviated (or crooked) septum. A true "septoplasty" does not involve changing the shape of the nose. The septum is the piece of cartilage that separates one side of the nose from the other. Normally, the septum is straight. When it is crooked, it is termed a deviated septum. A deviated septum can block the nasal passage and contribute to symptoms of nasal obstruction.

Correction of a deviated septum with a septoplasy involves making an incision on the inside of the nose. The skin covering the septum is lifted off the cartilage and the deviated setpum (intranasal part only) is either removed or reshaped to make the breathing passages more open. It is infrequent that a septoplasty alone will correct external crookedness.

For post-traumatic nasal deformities, particularly ones in which both the nasal bones and the septum are crooked, a septorhinoplasty (in which both the septum and the nasal framework are corrected) may be required.

Your best bet is to visit with one or more rhinoplasty specialists to make sure that your diagnosis is correct

Dallas Facial Plastic Surgeon
5.0 out of 5 stars 111 reviews

Septoplasty and Rhinoplasty are often done together.

In general, where there's a crooked or skewed external appearance, there's also a skewed or deviated septum. Typically, both the septum and the external framework of the nose need to be addressed at the same time. This, of course, means septoplasty and rhinoplasty (a.k.a., septorhinoplasty).

Closed approaches may work just fine, but my general preference is an open approach, especially for the crooked nose.

One important factor to consider, though, is whether the face itself is skewed. In some patients with a crooked nose, the actual problem is that the whole face is shifted...think of a parallelogram, for example versus a rectangle. In those cases, creating a vertically straight nose is going to be both impossible and inappropriate, but it's important that ones surgeon identifies this before surgery and discusses it with him. I hope this makes sense.

All the best,


David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Rhinoplasty, Septoplasty, or Both for Crooked Male Nose?

Hi Carter,

You need to decide if the external appearance of your nose bothers you. If it does, other than the crookedness, then you need to decide what features are bothersome, and what you would like it to look like after rhinoplasty. You should only make your nose smaller if it is something that has troubled you for some time.

Occasionally just straightening a deviated septum will correct a crooked nose. If the nose remains crooked after septoplasty, then other techniques are necessary to straighten the nose. It may require osteotomies (breaking the nasal bones), or adjustments to nasal cartilage. It may require the addition of grafts.

Most importantly, take your time to choose your nasal surgeon very carefully.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Nose and septum

It is tough to tell accurately from just a single picture and no physical examination.

Your nasal bones appear deviated. This should typically be repaired in addition to the septum. Also of any other aspects of the nasal appearance bother you, that would be the time. It would be a shame to throw away valuable nasal septal cartilage if it might help in the reconstruction of a droopy tip..

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 106 reviews

Septoplasty does not usually change the appearance of your nose.

If you're happy with the appearance of your nose, then you don't need a Rhinoplasty. If you'd like your nose straighter, and smaller, then Rhinoplasty would be suitable.

If you have chronic nasal blockage on one side only, then your septum is probably deviated towards the side of the blockage. Repairing that alone would not likely change the external appearance, but could improve your breathing.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 311 reviews

Crooked nose

The septum is the part of the internal structure of the nose. Addressing the septum will help improve your airway. Sometimes this is enough to help a patient. However, if there are structural problems with the nasal bones or cartilages, further surgery (rhinoplasty) will be necessary.

Sandy Sule, MD
Dallas Facial Plastic Surgeon
4.5 out of 5 stars 3 reviews

Septoplasty and Crooked Nose

Thank you for your question. Septoplasty is a surgical procedure which generally entails modification of the cartilage of the nasal septum. It is undertaken to improve symptomatic nasal airway obstruction when deviation or crookedness of the septum is judged to contribute to those symptoms. In most cases, septoplasty will not improve a crooked nose. If you find your nasal appearance to be unsatisfactory due the crookedness, you may be a candidate for rhinoplasty. If you find your nose overly large, rhinoplasty may be considered to diminish nasal size. Rhinoplasty is undertaken to improve the shape and/or size of the nose, and is usually required to improve nasal crookedness. For individualized advice, consult with a qualified nasal surgeon about your concerns. Good luck to you.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 48 reviews

Septoplaty versus Rhinoplasty

A septoplasty is reshaping of the cartilage of the nose, while a rhinoplasty is reshaping of the nose itself.  There are definite gray areas where a septoplasty and rhinoplasty can overlap, however, in general a septoplasty affects breathing while a rhinoplasty affects external shape.

If the desire is to create the straightest nose possible, often a septoplasty is combined with a rhinoplasty.  A deviated nose may have a deviated septum which likely needs to be addressed to help straighten your nose.  However, there are other components which can lead to a deviated nose including the nasal tip, nasal bones, etc.  This would be separate from a septoplasty and be considered a rhinoplasty procedure.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 93 reviews

Septoplasty vs. Rhinoplasty for Crooked Nose

Thank you for the question and your photo. Septoplasty is generally performed from inside the nose ("closed") and involves straightening the cartilage/bone in the septum to improve nasal breathing. In many case, the deviated or damaged portions of the septum need to be removed, while preserving the lining of the septum.  With a traditional septoplasty, no changes to the external nose are expected.  In the case of a crooked nose, typically from trauma, a "septorhinoplasty" may be indicated. In this procedure, the nasal bones may be reshaped using controlled fractures (osteotomies) to realign the external nose. In more complex cases, cartilage grafts may be needed to improve the airflow in the nose and/or the symmetry of the external nose. In these situations, an open approach is generally preferred.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Septoplasty and rhinoplasty in the treatment of the crooked nose

The terms septoplasty and rhinoplasty can be very confusing for patients.  Truly treating a crooked nose involved separating the five major aesthetic structural units from eachother, the paired upper lateral cartilages, the paired lower lateral cartilages and the septum.  Once this is completed, a submucuos resection of the central septum is completed.  It is only after these steps that the forces and form of each structure can be evaluated and treated.  The components are reattached using suture techniques to balance forces and grafts from the resected septum.  A rhinoplasty for crooked nose therefore technically always includes a septoplasty and a septoplasty alone will simply not treat a crooked nose efficaciously.  I hope this helps!


All the best,


Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.